Findings:
There is a 12 x 10 x 10 mm well circumscribed intrasellar mass centred in the left half of the anterior pituitary, displaying intrinsic hyperintense T1 signal and heterogeneous T2 signal with a hypointense area and no appreciable enhancement in keeping with hemorrhagic infarction. The lesion abuts the left cavernous sinus and the left ICA.
No obvious extension to the suprasellar cistern, no chiasmal compression.
The ventricles and sulcal spaces are within normal limits. The midline structures are normal with no midline shift.
The brain parenchyma is unremarkable without any obvious focal oedema. No abnormal signal on the susceptibility-weighted images or diffusion/ADC images is identified.
The orbits are unremarkable. Mucosal thickening is seen in the paranasal sinuses bilaterally. Minimal fluid is seen in the right-sided mastoid air cells.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Imaging findings are compatible with hemorrhage within a pituitary macroadenoma in keeping with pituitary apoplexy. Neurosurgical referral is advised.